For years, you’ve been shuffling between birth control options: popping a contraceptive pill every day, constantly checking the expiration dates on condoms and/or scheduling doctors’ appointments for injections or IUD insertions. Hopefully, these methods helped you time the births of your children to some degree. But if that chapter of your life is winding down, you might prefer a more permanent birth control method.

If you have a male partner, a vasectomy is considered by many doctors to be easier and less risky than a female sterilization. But if your partner doesn’t want the procedure — or if you have other reasons for choosing to be the one who’s sterilized — you might be considering the surgery yourself.

What is tubal ligation?

You’ve probably heard the term “getting your tubes tied,” if not “tubal ligation” (or possibly “tubectomy”). This procedure involves blocking or closing off a woman’s fallopian tubes, preventing eggs from traveling out of the ovaries and towards the uterus and the sperm from traveling up the fallopian tubes to the egg, ultimately preventing pregnancy.

What happens during a tubal ligation procedure?

What was once considered major abdominal surgery is happily now a much less invasive surgery that can be done in an outpatient setting. And since the 30-minute procedure will be performed under anesthesia (local, spinal or general), you won’t feel a thing.

The surgery is typically performed by a gynecologist, general surgeon or laparoscopic surgeon. In the days before your surgery, your practitioner may ask you to stop taking drugs that make it harder for your blood to clot (like aspirin and ibuprofen), and you’ll be asked to not eat or drink anything for the eight hours leading up to your surgery.

On the day of your tubectomy, your doctor will give you a pregnancy test just to be 100 percent sure that you’re not expecting. During the procedure itself, a small incision will be made in your abdomen — usually near your belly button — and the surgeon will pump a bit of gas into your belly and insert a light and a small tool through the incision so they can see your uterus and fallopian tubes.

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Then, depending what method your doctor prefers, they'll block off your fallopian tubes by either adding a clip, by adding a ring that holds the tubes into a small kink, by making a cut in the tubes or by burning a scar into the tubes (all of the approaches are effective).

As for cost? Thanks to the Affordable Care Act, insurance companies are required to completely cover the cost of tubal ligation surgery.

Is tubal ligation right for you?

Because it’s considered a permanent surgery, tubal sterilization is meant for you if you’re completely sure that you don’t want any more children.

Some women choose to have a tubal sterilization in conjunction with childbirth, since it can be done at the same time as a C-section or within about 48 hours after a vaginal delivery. (Many surgeons actually prefer to do this surgery after birth because you’re already in the hospital, and your abdominal wall is much more relaxed post-birth.) But you can also wait and have it done any time after that, too.

In recent years, some doctors increasingly opt to perform salpingectomy (which involves removing the fallopian tubes) as an alternate permanent method of birth control. Salpingectomy can help significantly reduce the risk of ovarian cancer. Ask your doctor what they recommend for you.

Who shouldn’t consider tubal ligation?

If you’re still on the fence about having more children, you might be a better fit for other forms of birth control. While you may have heard of people getting their tubal sterilizations reversed, definitely don’t get your tubes tied thinking you’ll just have the procedure reversed someday; that actually doesn’t work in all cases — plus it involves a second invasive surgery.

Since tubal sterilization involves surgery, if you’re obese, have chronic health conditions such as heart disease or if you’ve had complicated abdominal surgeries in the past, your doctor might recommend against the surgery.

How effective is tubal ligation?

Tubal sterilizations are more than 99 percent effective. As an added bonus, research shows tubal sterilization may also decrease your risk of ovarian cancer.

What kind of recovery should you expect after tubal ligation?

Since tubal ligation is considered a low-risk operation, you’ll be able to go home from the hospital the same day you have the procedure (just make sure you have a ride home!).

As with any surgical procedure, mild side effects can occur. The follow symptoms should subside after a few days:

Abdominal cramps
Gassiness or bloating
A swollen stomach or shoulder pain (from the gas inserted during the procedure)
Dizziness
Fatigue
Nausea
Sore throat (from the breathing tube if general anesthesia was used)
Slight vaginal bleeding (though if you had the procedure after childbirth you’ll have the normal post-delivery bleeding)

Doctors usually recommend taking a day off of work to rest. Try not to touch the incision for at least one week post-surgery to help healing and avoid infection of the incision site.

Your doctor will let you know when you can resume normal activities (that's usually within two to five days) and have intercourse (usually within a week), though again, if you had the procedure immediately after childbirth, you'll have the typical postpartum recovery.

Possible risks and complications after tubal ligation

If you notice a missed period or have a positive pregnancy test after tubal ligation, make sure to let your doctor know right away. After the surgery, there’s still a very slight chance you could get pregnant (about 0.5 percent), and you’re at increased risk of an ectopic pregnancy, when an egg is fertilized and implanted outside your uterus (usually in one of the fallopian tubes) — a condition that can be dangerous.

However, the vast majority of women will have no problems and find that tubal ligation is a worry-free, permanent method of birth control.

There are also some risks associated with getting your tubes tied that generally apply to any abdominal surgery, like bladder infections, damage to blood vessels or internal bleeding after surgery. But they’re relatively minor and quite rare; less than 2 percent of women who have the surgery experience complications.

There were warnings in the past that women who have tubal sterilization could suffer from something called “post-tubal ligation syndrome,” with symptoms ranging from depression and fatigue to increased premenstrual misery and longer periods to early menopause. While some women may experience symptoms like these after their surgery, experts say it can be attributed to stopping hormonal birth control or simply age; many women who have the surgery may have been nearing a time when their hormone levels are starting to change anyway.